In 2021, a new wind of creativity and dynamism blew through the department owing to the arrival of two new medical staff members. In the special hematology laboratory, the diagnostic protocols in morphology and flow cytometry were reviewed, with the recommendations for the research and interpretation of schistocytes updated accordingly. The search for short telomere syndromes based on the Flow-Fish technique has taken off, with increasingly numerous clinical indications, including pulmonary fibrosis, bone marrow aplasia, and several others. The research outcomes are critical for both optimally managing patients and genetic counseling of families.
High-throughput sequencing (NGS) has been revolutionizing routine medical practice in hemato-oncology for several years now. This targeted sequencing has enabled the search for markers with diagnostic, prognostic, or therapeutic value, thereby opening the way to a more personalized medicine. The hematology molecular biology laboratory has kept on developing this technology. As a result, NGS can now be carried out there for all the hematological-oncological pathologies provided for in the RIZIV-INAMI agreement. Efforts are also being focused on further developing the RNA sequencing technique recommended since 1/1/2022 for two onco-hematological pathologies.
The HLA system plays a central role in human immunity, whereas it also constitutes a major obstacle to organ transplantation. The involvement of anti-HLA antibodies in early and late rejection is currently indisputable. Given this context, the leuko-platelet immunology laboratory implemented a new test for identifying clinically more relevant anti-HLA antibodies in order to facilitate graft allocation.
COVID-19 has not spared the hematological biology department, playing spoilsport at the Blood Bank. Indeed, not only were the transfusion needs of certain Sars-CoV-2-infected patients rather substantial, but the erythrocyte immunology laboratory was confronted with detecting virus-induced anti-erythrocyte autoantibodies, thereby interfering with routine tests while rendering the search for compatible blood at times even more complex.
One of the Transfusion Committee’s objectives in 2021 was to further develop "Patient Blood Management" (PBM) within the various departments at Cliniques universitaires Saint-Luc. The neonatology department was chosen to be the pilot department, with the intention to work on the second PBM pillar, meaning to minimize blood loss by reducing blood sampling in infants. A decision-making flowchart was established and presented to the pediatric medical and nursing teams prior to being implemented.
These different initiatives have been made possible only through the work of the different departmental teams, at all times seeking to fully respect the patient while offering them optimal care.
Key Words
Schistocyte, Flow-Fish, telomere length, NGS, HLA, transplantation, COVID-19, Direct antiglobulin test, Patient Blood Management, transfusion in neonates